16 Jun Question PBL Case Discussion: Issues in Grow
Question
PBL Case Discussion: Issues in Growth and Behavior Part One (graded)
Today you note that Kayla is back with Jo for behavioral issues.
HPI: Kayla (mom) is back to visit with Jo, the 5 & 8/12 year-old female child. She is here for complaints of behavioral difficulties and poor performance in school. Mother reports since moving back in with her parents that Jo has started throwing tantrums and refusing to obey. The mother reports that she has always been active with frequent changes in activity and difficulty in staying seated or minding her own business. However, since the move and starting kindergarten, others have commented on difficulties in behavior, including Kayla’s own parents and Jo’s teacher. She is doing poorly in school and has had many behavioral issues there and been sent to the principal’s office on three occasions. She has not yet been to see the opthamologist as you suggested.
PMH: No change in diet; no fever; no communicable disease symptoms; continues children’s chewable multivitamin with iron daily; sleep includes going to bed around 10:30 p.m. at night and being awakened at 6 a.m. for school. She continues to be difficult to get in bed with frequently getting up in the first hour of bedtime.
Discussion Questions Part One
What additional OLDCART and ROS information would you like? Why?
Differential diagnoses with rationale?
Further history and ROS needed to more fully develop your differential diagnoses?
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